Objective By investigating the prevalence of refractive errors in older adults in rural populations in Tongxin county, Ningxia Hui Autonomous Region, it was feasible to get more actual data on the prevalence of blindness and low vision before and after refractive correction. Methods A population-based cross-sectional study was carried out. A questionnaire was designed for people aged 50 or older in Tongxin county, Ningxia, to obtain a general medical history, dietary habits, previous ocular history and treatment. Measurements were taken, including visual acuity, intraocular pressure, refraction, slit-lamp microscopy and non-mydriatic digital fundus photography in order to analyze the distribution of people with refractive errors associated with gender, age, education level and different ethnic groups, as well as etiological factors causing prevalence and noncorrectable vision with different refractive conditions. Visual impairment standards that included best-corrected visual acuity (BCVA) and presenting visual acuity (PVA) were used to analyze the prevalence of blindness and low vision before and after refractive correction. A Chi-square test was used for comparing the rate among groups. Results There were 5 493 people aged 50 or older in the rural population in Tongxin county, among which 5 046 people completed the examination, sponse rate were 91.86%, and 2 116 of them were diagnosed with ametropia, a prevalence rate of 41.93%. Based on PVA and BCVA, the prevalence of blindness was 5.35% and 2.02％, respectively, and the difference was statistically significant (χ2=78.78, P<0.01). Similarly, based on PVA and BCVA standards, the prevalence of low vision was 15.28％ and 5.77％, respectively, which was statistically significant (χ2=244.54, P<0.01). The prevalence of ametropia in different educational levels: under primary school, primary school, middle school, senior high school and above was 45.94%, 36.42%, 25.38%, and 33.79%, the differences were significant (χ²=97.89, P<0.01). The prevalence of Hui and Han nationalities was 43.33% and 35.92%, respectively. The prevalence rate of the Hui population was higher than the Han population (χ2=17.40, P<0.01). Conclusion Prevalence of refractive error is 41.93% in Tongxin County, Ningxia. Prevalence of refractive error is different in different age, eductional levels, ethnic group. Blindness and low vision impairment could be eliminated in most elderly people with refractive correction.